Instructional Use Statement

The following information is used for instructional purposes for students enrolled in the Physical Therapist Assistant Program at Lane Community College. It is not intended for commercial use or distribution or commercial purposes. It is not intended to serve as medical advice or treatment.

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Vital Sign Basics

Your text book is your best resource for learning about vital signs and their role in selecting PT interventions. Complete the assigned reading and use the study guide to help you focus on the main points.

Pain Assessment Tools

There is a variety of general-to-specific methods of measuring and documenting pain. Next week, you have an essay on the clinical application of pain scales. A few are included in your text, and I have linked some additional, standardized assessment tools for pain in the table below. Standardized measures can be very powerful tools to document changes in quality of life and in functional activities as a result of physical therapy. Progress and declines (regressions) are easily supported by changes in pain measures.

You can prepare for your essay assignment and for the exam/lab by completing the following table

Note taking table for comparing/contrasting pain scales

Assessment Tool

Advantages

Disadvantages

Visual Analog Scale (VAS)

Faces Pain Rating Scale

Mc Gill Pain Questionnaire

Oswestry Disability Questionnaire

When you were observing therapists at the clinic, how did therapists gather information about pain? Think about age, culture, cognition (thinking), time, relevance, and function. All of the assessment tools listed above are used to collect data about pain. Could you explain to your supervising PT why you selected a particular tool? Critical thinking wtih decision-making is demonstrated by your ability to provide a rationale for your choice that is patient-specific and evidence-based.

Documentation

Vital signs are objective data that provide information about physiological status and responses to stress. Ideally, vital signs are collected before engaging in physical activity, particularly in the deconditioned population. When vital signs are abnormal, the PTA may need to modify treatment approaches or consult with their supervising PT or nursing staff. Documenting vital signs taken throughout the physical therapy session provide evidence of ongoing patient assessment and monitoring.

PTAs make informed decisions when selecting exercises and other interventions by interpreting vital sign measures prior and during treatment. Document findings using consistent terminology and include patient position/situation (lying, sitting, standing) so that the data is transferable and can be interpreted by a multidisciplinary team. Pain documentation should include a rating, location, and other information about its quality.

:

Vital Sign

Documentation

Heart Rate (HR)

# bpm

Respiratory Rate (RR)

# / min

Blood Pressure (BP)

systolic (mm Hg)/ diastolic (mm Hg)

Temperature (temp)

°C or °F

Pain (pn)

# / 10, or other standardized measure

Oxygen Saturation (O2 sat)

# %

Sample chart note excerpt

S: Pt lying with HOB elevated. Eager to work on getting OOB. Slept better last NOC. Agreeable to in bed exs.

Role of the PTA

PTAs measure vital signs and make comparisons from previously collected, baseline data. PTAs also use observation skills to monitor for signs and symptoms of an abnormal temperature, HR, BP, RR, or pain response before, during, and after therapy.

PTAs confirm that it is safe to proceed with activity.

PTAs document responses to treatment and make decisions about treatment progressions and modifications by integrating findings from vital sign measurements

PTAs are a part of an interdisciplinary team which integrates pain assessment and pain management into every treatment plan across settings and across the life span

PTAs select appropriate pain assessment tools based on the abilities and condition of the patients

PTAs promote health and wellness education by providing community members resources and advice on tips for maintaining a healthy blood pressure. This includes informing clients about what they can control (e.g. lifestyle habits)

Exam Success

Can you recall normal and abnormal values for the vital signs?

Can you use correct medical terminology to describe/document an abnormal finding?

Can you describe lifestyle factors which may impact vital sign measures?

Do you understand the benefits and challenges of pain assessment tools covered in this unit?

Can you describe typical pain patterns specific to involved structures?